RESIDENCY RECLASSIFICATION APPLICATION
|
|
- Jemima Cook
- 6 years ago
- Views:
Transcription
1 North Carolina A&T State University The Graduate College 1601 East Market Street 120 Gibbs Hall Greensboro, NC RESIDENCY RECLASSIFICATION APPLICATION Under North Carolina law, a person may qualify as a resident for tuition purposes in North Carolina, thereby being eligible for a tuition rate lower than that for non-residents for tuition purposes. Copies of the applicable law and of implementing regulations are available at the University library and In essence, the controlling North Carolina statute (G.S ) requires that to qualify as a resident for tuition purposes, a person must have established a legal residence (domicile) in North Carolina and maintain that legal residence at least 12 months immediately prior to his or her classification as a resident for tuition purposes. G.S also set forth statutory definition, rules and special provisions for determining residency status for tuition purposes. These provisions include special rules with respect to persons who are married, in the military, minors, and employees of the UNC System or are immediate relatives of deceased North Carolina emergency workers. Certain non-us citizens may also qualify for resident tuition status. Additional information may be obtained from NC A&T website at: IMPORTANT: PLEASE READ THESE INTRUCTIONS BEFORE COMPLETING APPLICATION. A. Answer all questions. If any question is not applicable to your situation, write N/A or not applicable. Please provide your Banner ID at the top of each page in the space provided. B. Print legibly or type all responses. If necessary, write see attached in the spaces provided and use separate additional sheets, numbering your responses the same as the corresponding question and stapling these sheets to the application. C. Provide accurate responses. To the best of your knowledge and understanding, answer each question correctly. Knowingly falsifying your responses may subject you to disciplinary action, including dismissal from the institution. Whenever a date is requested, give month/day/year. D. Sign and date the application. Failure to make the necessary acknowledgements and certification renders this an invalid application. E. Submit the application by the date requested. All applications must be submitted to the University by close of business on the 10th business day of class of the academic term for which an applicant wishes to be considered for a change in residency and tuition status. F. Attach copies of all supporting documents. Do not submit originals. The University cannot make copies. G. All documents need to be provided with the application at submission. A decision will be rendered with the documents that are provided at the point of application.
2 1. Applicant s Full Name: Last Name First Name Middle Initial 2. Phone Number: 3. Date of Birth: Place of Birth: 4. Do you claim to be legal resident of the North Carolina? Yes No If so, from what date? 5. Circle term in which you are seeking residency reclassification. Year Fall Spring Summer 6. Address while attending this institution (current, not past): 7. Permanent home address: County: 8. Previous home address in North Carolina was: From (date): To (date): 9. Are you currently enrolled in this institution? Yes No Classification: Graduate Major 10. Secondary (or preparatory) school you attended, in sequence. Name Address (including city/state) From To 11. Post-secondary school(s) (universities, colleges, junior colleges, community colleges, etc.) you have attended, in sequence (including this institution). Name Address (including city/state) From To
3 12. Has your residency status for tuition purposes ever been previously determined by any North Carolina public educational institution? Yes No If yes, (a) Name of institution: (b) Classification: Resident Nonresident (c) Last term and year you were classified: (this will be verified) 13. Father living? Yes No Name Permanent home address: Since (Date) Occupation 14. Mother living? Yes No Name Permanent home address: Since (Date) Occupation 15. Are your parents separated or divorced? Yes No If yes, who has custody of children? 16. Legal guardian of the applicant? Name: Permanent home address : Since (Date): Occupation: 17. Why and when did you relocate to North Carolina? (Reason): (Date): 18. When and from what state or foreign country did you relocate? Moved from: on (date): 19. When did you begin your legal residence (domicile) in North Carolina? Date:
4 20. Who (including yourself) last claimed you as a dependent on State and/or Federal income tax returns? What tax year, and in what state filed? (a) State Return for tax year, filed (State) Name (b) Federal Return for tax year, filed (State) Name (c) Is it the present intention of anyone (including yourself) to claim you as a dependent on State and/or Federal income tax returns for the current tax year? Yes No If so, who? Relationship to you: In what state(s) will the tax return be filed? 21. Name each state or foreign country (1) where you did any of the following within the last 24 months or (2) if not done in the last 24 months, where such acts were last done. (Provide month, day, and year of each act; if never done, write never.) Voted State/ Foreign Country Month/ Day/ Year Registered to Vote State/ Foreign Country Month/ Day/ Year Requested/served on jury duty State/ Foreign Country Month/ Day/ Year Acquired or renewed driver s license State/ Foreign Country Month/ Day/ Year Filed state income tax return State/ Foreign Country Month/ Day/ Year
5 (a) If this was a North Carolina return, did you show on this return that you were a non-resident of North Carolina, for any period of the tax year? Yes No If yes, what period? (b) If this was not a North Carolina return, did you show on this return that you were a resident of North Carolina for any period of the tax year? Yes No If yes, what period? (Please list state, foreign country, month, day and year for each as they apply.) (c) Had state income tax withheld during the current tax year: State Country Month/ Day/ Year (d) Filed state intangible tax return: State Country Month/ Day/ Year (e) Acquired ownership of property for use as your principal dwelling: State Country Month/ Day/ Year (f) Registered/licensed a motor vehicle (car, truck, or other requiring license): State Country Month/ Day/ Year 22. List all registered vehicles: Type of vehicle (list all) Where registered/ licensed Date 23. The car(s) or other motor vehicle(s) you maintain and operate in North Carolina are owned by (name and address): The above items are registered/ licensed in what state? 24. The car(s) or the other motor vehicle(s) you maintain and operate in North Carolina are insured in the name of (name and address):
6 25. List the addresses at which you own and maintain personal property (clothing, furniture, cars, boats, savings accounts, pets, jewelry, appliances, etc.) and give percentage value (of total personal property) maintained at each address. Address % at this address 26. List of employment for wages in the last 24 months: Employer Address (city/state) Dates Hours per week 27. List the sources and uses of the money required to meet your expenses: Current Calendar Year Preceding Calendar Year Source % of Total Used for % of Total Used for Your Earnings Parent(s) or Guardian(s) Spouse Other Specify other: 28. Are you now in, or a veteran of, active military service or other Federal Government employment? Yes No If answer is yes, provide your home address upon entry: (a) Your official home address now: (b) Date this home address was declared: (c) Your official home of record :
7 (d) Legal residence you most recently claimed on DD Form 2058 (State Legal Residence Certificate): (e) Date you completed the DD Form 2058: (f) Your address upon discharge: 29. If you (1) now live regularly with, (2) have lived with during the immediate preceding 24 months, or (3) continue to maintain close ties with and periodically live with another person who is a relative by blood, marriage, or court order of a legal guardian of the person, or (4) have been claimed within the immediately preceding 24 months as a dependent for taxation purposes by someone other than yourself, answer the following for each such person: (Answer for spouse if separation occurred within the last 24 hours. Complete for spouse if divorce occurred within last 24 months. Complete for ex-spouse.) (a) Name: Relationship to you: Permanent home address: From (date): to (date): Is any such person a veteran, currently active, or has been an active member of military service or other Federal Government employment? If answer is yes, provide the following for each such person: Home address upon entry: Official home address now: Date this home address was declared: Official home of record : Legal residence most recently claimed on DD Form 2058 (State of Legal Residence Certificate): Date DD Form 2058 was completed: Address upon discharge: Place to which mileage paid upon discharge: (b) Places (states or foreign countries) and dates where each of the following acts (1) was performed by each person within the last 24 months or (2) if not done in the last 24 months, where such person did each act. (If never done, write never.) Date Acts State/ Foreign Country Month/Day/Year Vote Registered Served on jury duty Acquired driver s license Filed State income tax returns
8 If this was a North Carolina return, did the taxpayer show on the return that he/she was a non-resident of North Carolina for any period of the tax year? Yes No If yes, what period? Date Acts State/ Foreign Country Month/Day/Year Filed state intangible tax return Listed personal property for taxation Acquired ownership of property for use as principal dwelling Inclusive dates of such property ownership from (date) to (date) Date Acts State/ Foreign Country Month/Day/Year Registered/ licensed motor vehicle(s) Claimed you as an exemption on State income tax return Federal income tax return 30. If you are an alien, answer and complete the following appropriately: (a) I possess a valid, current visa Yes No (i.e., A, B, C, D, E, F, G, H, J, K, L, OR M number). (Note: B, C, D, F, J and M visas reflect a presence in the United States not sufficient to support a bona fide claim to North Carolina legal residence.) My visa was issued on (date) (b) I possess a valid, current Form I-151 or I-551 Alien Registration Receipt Card. Yes No Registration Number It reflects my entry into the United States as an immigrant on (date): (c) I possess a valid, current Form I-181b, Memorandum of Creation of Record of Lawful Permanent Residence. Yes No It reflects my entry into the United States as immigrant on (date) (d) Immediately before I received my Form I-151 Form I-551 or Form I-181b: I possessed a valid current visa. Yes No This was an immigrant visa. Yes No This was a visa with letter designation of: My visa was issued on (date): (e) I possess a valid, current Form I-94 (Arrival/ Departure Record) Parole Edition. Yes No The parole date on this form (f) I possess a document issued by Immigration authorities (letter, form, certificate, etc.) that shows I will later be issued one or more of the documents above. Yes No Its effective date is Documentation attached: Yes No (If not, be prepared to display the document for inspection upon request.)
9 31. Describe any other circumstances, events, or acts, specifying their place and date, you feel will support your claim to be a North Carolina resident for tuition purposes. Documentation Requirements In support of your claim to North Carolina as your bona fide permanent residence you must attach copies of all your (and/or your parents or guardians) residentiary acts, including, but not limited to: Deed/lease agreements or notarized statement from landlord Driver s License or State ID Vehicle Registration Voter Registration Federal and State tax returns Parent s Federal and State tax returns Year-to-date cumulative wage statements from all jobs held during the year Permanent Residency Card (Green Card) US Citizenship Naturalization Document Review the following and initial upon completion. I hereby acknowledge that providing my Social Security Number is voluntary, is requested by the institution solely for administrative convenience and record-keeping accuracy, and is requested only to provide a personal identifier for the internal records of this institution. I hereby certify all information I have set forth herein is true to the best of my knowledge, pursuant to my reasonable inquiry where needed. I hereby acknowledge the institution may verify the information set forth herein from sources accessible under law to the institution but the institution may divulge law to the contents of this application only as permitted under the Family Educational Rights and Privacy Act of 1974 if I am, or have been, in attendance at this institution. Applicant s Signature Date Signature of parent or legal guardian (Required if applicant is less than 18 years of age) Date Return completed application to: North Carolina A&T State University The Graduate College 1601 East Market Street 120 Gibbs Hall Greensboro, NC 27411
For Office Use Only. Decision: Effective Date: Date application completed: Signed: Date: Case/File I.D.:
For Office Use Only Student Date application initially filed: Date application completed: Term for which application applies: Date of first day of classes for which applicant seeks reclassification: Application
More informationFor Office Use Only. Student Decision: Date application initially filed: Effective Date: Date application completed: By:
For Office Use Only Student Decision: Date application initially filed: Effective Date: Date application completed: By: Term for which application applies: Signed: Institutional Official OATH AND AUTHORIZATION
More informationFOR OFFICE USE ONLY - DO NOT WRITE IN THIS SPACE. Tuition Classification Decision Approved Denied Date. Effective, 20 Decision Made By:
FOR OFFICE USE ONLY - DO NOT WRITE IN THIS SPACE Tuition Classification Decision Approved Denied Date Effective, 20 Decision Made By: Covell Decision yes no Remarks: ******************************************************************************************************
More informationDO NOT WRITE IN THIS SECTION For Office Use Only
DO NOT WRITE IN THIS SECTION For Office Use Only Name of Applicant Case/File No Semester School/College Application Deadline Date Filed Determination Level Effective Reference Findings Signed Date Determination
More informationFor Office Use Only STATEMENT AND AFFIDAVIT FOR RESIDENCY CLASSIFICATION AT KENTUCKY PUBLIC COLLEGES AND UNIVERSITIES
For Office Use Only Student Date application initially filed: Date application completed: Term for which application applies: W O S Decision: Date: Case/File I.D.: Signed: Institutional Official Routine
More informationFor Office Use. Signed:
For Office Use Student Date application initially filed: Date application completed: Term for which application applies: Decision: Date: Case/File I.D.: Signed: W O S Routine audit scheduled for OATH AND
More informationRESIDENCY QUESTIONNAIRE
ADMISSIONS & RECORDS OFFICE 1900 Pico Blvd. Santa Monica, CA 90405 Phone: 310-434-4380 Fax: 310-434-3645 RESIDENCY QUESTIONNAIRE Received by: Date: The information requested is deemed relevant and necessary
More informationRESIDENCY QUESTIONNAIRE
RESIDENCY QUESTIONNAIRE Before completing this questionnaire, please read this pamphlet carefully and the questionnaire instructions. Please check the appropriate box or supply the requested information.
More informationRAWLINS FIRE DEPARTMENT PO BOX 953 RAWLINS, WY FAX Website:
PERSONAL HISTORY STATEMENT The following information is requested of you for verification and contact purposes: (Please Print or Type) 1. Your Name Last Name: First Name: Middle: Other Names (including
More informationCity of Staples Application for Employment
City of Staples Application for Employment We consider applicants for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran status, the presence of a non-job-related
More informationHave you ever applied for employment with us before: Yes No If yes, when? PERSONAL DATA Last Name First Name Middle Home Phone Number With area code
City of Greenbush 244 Main Street rth PO Box 98 Greenbush, MN 56726 (218) 782-2570 Employment Application It is our policy to provide equality of opportunity in employment. This policy prohibits discrimination
More informationAPPLICATION FOR RECLASSIFICATION OF RESIDENCY STATUS FOR TUITION AND FEE PURPOSES
APPLICATION FOR RECLASSIFICATION OF RESIDENCY STATUS FOR TUITION AND FEE PURPOSES Instructions The student should complete this form. Put a check mark beside ONE Category in (Part 2), and complete the
More informationFinancial Aid Office. APTS Checklist DID YOU REMEMBER TO: 1. Sign your New York State tax return? Did your parent s sign their return?
Financial Aid Office APTS Checklist DID YOU REMEMBER TO: 1. Sign your New York State tax return? Did your parent s sign their return? 2. Submit your signed copy of your 2016 New York State tax return?
More informationAID FOR PART TIME STUDY (APTS) APPLICATION
2017-2018 AID FOR PART TIME STUDY (APTS) APPLICATION Aid for Part Time Study (APTS) is a grant for matriculated New York State residents enrolled in at least 3-11credits per semester Students must maintain
More informationTerms & Conditions You must be enrolled in credits that are applicable towards your degree or major requirements.
For Office Use Only: COMMKEY 9APTS Posted By: Name: Stony Brook ID: Aid for Part-Time Study (APTS) The Aid for Part-Time Study (APTS) program provides grant assistance for eligible part-time students enrolled
More informationSECU Foundation Scholarship Information
To be considered, the student MUST: SECU Foundation Scholarship Information Be enrolled in a Continuing Education program at Coastal Carolina Community College that leads to a state-regulated or industry
More informationAID FOR PART-TIME STUDY (APTS) APPLICATION
Financial Aid and Student Records Admissions Center, Room 112 PO Box 6000 Binghamton, New York 13902-6000 Phone: 607-777-2428 Fax: 607-777-6897 Email: finaid@binghamtonedu wwwbingfabinghamtonedu 2017-2018
More informationAid For Part-Time Study (APTS)
Aid For Part-Time Study (APTS) 2019-20 If you plan on attending Genesee Community College during the 2019-20 academic year, you may be eligible for APTS. 1. Complete the APTS application. 2. If you (and
More informationAID FOR PART-TIME STUDY (APTS) APPLICATION
Financial Aid and Student Records Admissions Center, Room 112 PO Box 6000 Binghamton, New York 13902-6000 Phone: 607-777-2428 Fax: 607-777-6897 Email: finaid@binghamtonedu wwwbingfabinghamtonedu 2018-2019
More informationAPPLICATION FOR FINANCIAL AID
Recent Photo APPLICATION FOR FINANCIAL AID ID# Applying for semester 1. Name Last In Arabic First Academic year Other last names that may appear on previous academic transcript Middle (Full name as it
More informationPlease note the following important provisions pertaining to the APTS program:
Before you submit your APTS Application for 18/19 Deadlines: Sept 28, 2018 (Fall 2018 term) Jan 25, 2019 (Spring 2019 term) If you will be part-time for both terms, only one application is needed You must
More informationNoncustodial Parent Information
Student Financial Services University of Pennsylvania 005 Franklin Building 3451 Walnut Street Philadelphia, PA 19104-6270 www.sfs.upenn.edu Noncustodial Parent Information Canadian Citizens Academic Year
More informationKalamazoo College International Financial Aid Application
Kalamazoo College International Financial Aid Application Section 1 1. Student s Name: Last (Family) First (Given) Middle 2. Primary Address: 3. Mailing Address: (if different from #2) 4. Email address:
More informationAID FOR PART TIME STUDY
Financial Aid Office 136 Clinton Point Drive Plattsburgh, NY 12901 P (518) 562-4125 F (518) 562-4373 wwwclintonedu/financialaid AID FOR PART TIME STUDY Complete a 2017-18 FAFSA Complete the APTS application
More informationCITY OF GRAIN VALLEY.
CITY OF GRAIN VALLEY EMPLOYMENT APPLICATION DEPARTMENT OF HUMAN RESOURCES 711 Main Street Grain Valley, Missouri 64029 Phone: 816.847.6210 Fax: 816.847.6202 Website: www.cityofgrainvalley.org NOTICE TO
More informationAID FOR PART TIME STUDY (APTS) Application Instructions
2013-2014 AID FOR PART TIME STUDY (APTS) Application Instructions Your APTS application will be used for determining eligibility for both the Fall 2013 and Spring 2014 semesters (you do not need to submit
More informationQUESTIONNAIRE - RESOLUTION INFORMATION PACKET
QUESTIONNAIRE - RESOLUTION INFORMATION PACKET FOR INDIVIDUALS AND SOLE PROPRIETORSHIPS In order to achieve the best possible resolution with the Internal Revenue Service, please complete the following
More informationESTATE PLANNING INFORMATION QUESTIONNAIRE (SINGLE PERSON)
ESTATE PLANNING INFORMATION QUESTIONNAIRE (SINGLE PERSON) Date: 1. Personal Information: Full Name: Social Security #: Date of Birth: Place of Birth: Address: Home Phone: Work Phone: Cell Phone: Facsimile:
More informationCity of Becker Employment Application
Date Received: Received By: City of Becker Employment Application Return to: Becker Community Center PO Box 250 Becker, MN 55308 Ph: 763-200-4271 Fax: 763-261-2018 Applicant Name: Last First Middle Initial
More informationEmergency Assistance Request Form
Emergency Assistance Request Form FOR DEPARTMENT USE ONLY AMOUNT TYPE OF ASSISTANCE APPROVED BY PROJECT: VetRelief provides support for active duty military, our veterans, and their families who reside
More informationSummer Academy in Applied Science and Technology School of Engineering and Applied Science, University of Pennsylvania
Summer Academy in Applied Science and Technology School of Engineering and Applied Science, University of Pennsylvania SUMMER 2015 FINANCIAL AID APPLICATION FORM For US Citizens Please submit a copy of
More informationNoncustodial Parent Information
Student Financial Services University of Pennsylvania 005 Franklin Building 3451 Walnut Street Philadelphia, PA 19104-6270 www.sfs.upenn.edu Noncustodial Parent Information U.S. Citizens and Permanent
More informationPost-Doc, Post-Doc Trainee & Instructor
Post-Doc, Post-Doc Trainee & Instructor NEW-HIRE DOCUMENTS: Emergency Contact Information Form New Employee Disclosure Form Release of Reference Form Request for Verification of Prior State Service Form
More informationExterior Accessibility Grant Program
City of Davenport Community Planning and Economic Development Exterior Accessibility Grant Program This application is for use in determining eligibility for the City of Davenport s Exterior Accessibility
More informationIndependent Student Verification Worksheet
Financial Aid Office 2400 Ridge Road, Berkeley, CA 94709-1212 Email: finaid@gtu.edu Fax: 510.649.1730 2019-2020 Independent Student Verification Worksheet If your 2019-2020 Free Application for Federal
More informationInstructions for Form W-7
Instructions for Form W-7 (January 2010) Application for IRS Individual Taxpayer Identification Number Department of the Treasury Internal Revenue Service Section references are to the Internal Revenue
More informationCommunity Planning and Economic Development Homebuyer Down Payment Grant Program
Community Planning and Economic Development Homebuyer Down Payment Grant Program This application is for use in determining eligibility for Down Payment Assistance Program. You must have been pre-approved
More informationChelsea Housing Authority 54 Locke Street Chelsea, Massachusetts 02150
THIS BOX IS FOR OFFICE USE ONLY STANDARD APPLICATION FOR FEDERAL-AIDED PUBLIC HOUSING. Date of receipt: Time of Receipt: Control Number: Barrier Free: First Floor: Elderly/Handicapped: Bedrooms: Race:
More informationCOMPANY NAME: WinnResidential Phone: (202) Third Street SE, Suite 200 Fax: (202) Washington, DC 20032
Elementary, Middle or High School College, University, or Trade School COMPANY NAME: WinnResidential Phone: (202) 561-8600 4319 Third Street SE, Suite 200 Fax: (202) 516-8054 Washington, DC 20032 Email:
More informationMontana State University MESA Program POTENTIAL PARTICIPANT APPLICATION FORM
Montana State University MESA Program POTENTIAL PARTICIPANT APPLICATION FORM Date: / / To ensure you qualify for the Matched Education Savings Account (MESA) Program, please read the MESA Frequently Asked
More informationName: Last First Middle. Present Address: Street City State. Permanent Address: Street City State. Phone No: Referred by:
APPLICATION FOR EMPLOYMENT SUMTER COUNTY PROPERTY APPRAISER We are an equal opportunity employer dedicated to non discrimination in employment on the basis of race, color, age, religion, sex, national
More informationStudent Financial Statement
Student Financial Statement Academic Year 2019-20 Guidelines for completing the 2019-20 Bard College Berlin Student Financial Statement Students wishing to apply for need-based financial aid and scholarships
More informationStudent Financial Statement
Student Financial Statement Academic Year 2018-19 Guidelines for completing the 2018-19 Bard College Berlin Student Financial Statement Students wishing to apply for need-based financial aid and scholarships
More informationVASILIADIS PAPPAS ASSOCIATES LLC 2551 Baglyos Circle, Suite A-14 Bethlehem, PA Phone: (610) Fax: (610)
VASILIADIS PAPPAS ASSOCIATES LLC 2551 Baglyos Circle, Suite A-14 Bethlehem, PA 18020 Phone: (610) 694-9455 Fax: (610) 694-9829 www.lawvp.com PERSONAL PROFILE I. PERSONAL INFORMATION 1. Client name: (Last)
More informationSTANDARD COMMERCIAL FISHING LICENSE (SCFL) OR RETIRED STANDARD COMMERCIAL FISHING LICENSE (RSCFL) TRANSFER APPLICATION INSTRUCTIONS
STANDARD COMMERCIAL FISHING LICENSE (SCFL) OR RETIRED STANDARD COMMERCIAL FISHING LICENSE (RSCFL) TRANSFER APPLICATION INSTRUCTIONS This application is to be completed and signed by individuals who are
More informationSTATEMENT FOR DETERMINING CONTINUING ELIGIBILITY FOR SUPPLEMENTAL SECURITY INCOME PAYMENTS
UPDATE FORM APPROVED SOCIAL SECURITY ADMINISTRATION OMB. 0960-0416 STATEMENT FOR DETERMINING CONTINUING ELIGIBILITY FOR SUPPLEMENTAL SECURITY INCOME PAYMENTS EI SSN For Official Use Only Name and Address
More informationa. Family b. Elderly/ Handicapped c. Handicapped d. MRVP
LEXINGTON HOUSING AUTHORITY One Countryside Village Lexington, MA 02420 781-861-0900 STANDARD APPLICATION FOR STATE-AIDED HOUSING THIS BOX IS FOR OFFICE USE ONLY Date of receipt: Time of Receipt: Control
More informationFlorida Agricultural and Mechanical University Tallahassee, Florida
Division of Student Affairs Office of Financial Aid Florida Agricultural and Mechanical University Tallahassee, Florida 32307-3100 TELEPHONE: (850) 599-3730 FAX: (850) 561-2730 2017-2018 Special Circumstance
More informationEMPLOYMENT APPLICATION
EMPLOYMENT APPLICATION POSITION APPLYING FOR: APPLICATION DATE: PERSONAL LAST NAME FIRST NAME MI PRIOR NAME(S), IF APPLICABLE MAILING ADDRESS CITY STATE ZIP WORK PHONE HOME PHONE CELL PHONE EMAIL ADDRESS
More informationInternational Student Financial Aid Application
International Student Financial Aid Application 2015 2016 Eastern Nazarene College Instructions for Completing the 2015-2016 International Student Financial Aid Application The International Student Financial
More informationMAYOR BYRON W. BROWN S SUMMER YOUTH INTERNSHIP PROGRAM APPLICATION
MAYOR BYRON W. BROWN S SUMMER YOUTH INTERNSHIP PROGRAM February 1, 2018 Dear Applicant: Thank you for your interest in applying for my 2018 Summer Youth Internship Program. This is truly a wonderful opportunity
More informationQUESTIONNAIRE: DETERMINATION OF RESIDENCY STATUS ENTERING THE REPUBLIC OF SLOVENIA. Identification of Individual Name: Tax ID No.
QUESTIONNAIRE: DETERMINATION OF RESIDENCY STATUS ENTERING THE REPUBLIC OF SLOVENIA Identification of Individual Name: Tax ID No.: Tax year: Address in the Republic of Slovenia: Telephone: Address abroad
More informationNon-Resident Alien Frequently Asked Questions
Materials Management: Payroll Time and Attendance Unit Non-Resident Alien Frequently Asked Questions TAX FILING: DO I NEED TO FILE / WHEN DO I FILE? What happens if I fail to file my taxes? If you owe
More informationTOWN OF TUFTONBORO PO BOX 98, 240 MIDDLE ROAD CENTER TUFTONBORO, NH Telephone (603) Fax (603)
TOWN OF TUFTONBORO PO BOX 98, 240 MIDDLE ROAD CENTER TUFTONBORO, NH 03816 Telephone (603) 569-4539 Fax (603) 569-4328 APPLICATION FOR GENERAL ASSISTANCE Date of Application Referred by: Name Street Address
More informationCSS/Financial Aid PROFILE Early Application School Year
Section A --- Student s Information 1. Student s Name: Last Name First Name M.I. 2. Student s permanent mailing address: Street address City Zip or Postal Code Country 3. Student s preferred telephone
More informationSpecial Circumstances Form
2019-2020 Special Circumstances Form Occasionally, unusual circumstances exist that may warrant reconsideration of financial aid eligibility. If the information you reported on your Free Application for
More informationDraft Not for Reproduction 05/18/2016
Instructions for Request for Reduced Fee Department of Homeland Security U.S. Citizenship and Immigration Services USCIS Form I-942 OMB No. 1615-0116 Expires 05/31/2015 What Is the Purpose of Form I-942?
More informationUNIVERSITY OF DAYTON NONRESIDENT ALIEN TAX GUIDE CONTENTS COMMON VISA TYPES AND THEIR TREATMENTS
UNIVERSITY OF DAYTON NONRESIDENT ALIEN TAX GUIDE CONTENTS I. RESPONSIBILITIES II. III. IV. SOCIAL SECURITY NUMBER REQUIREMENT DEFINITIONS TAX TREATIES V. PAYMENTS TO NONRESIDENT ALIENS VI. COMMON VISA
More informationPLEASE RETAIN THIS PAGE FOR YOUR RECORDS
RETURN TO WORK POLICY If you are receiving an early or normal retirement benefit: You must immediately notify the NEBF if you return to work in the electrical industry for forty (40) or more hours per
More informationSection A: Household information Please complete all boxes for persons listed
2018-2019 V5 Verification Worksheet Independent Student Your 2018-2019 Free Application for Federal Student Aid (FAFSA) was selected for verification. Bluefield College Financial Aid Office will compare
More informationCuster County Sheriff s Office
Custer County Sheriff s Office Employment Application Equal Opportunity Employer It is our policy to abide all Federal and State laws prohibiting employment discrimination solely on the basis of a person
More informationIf you have any questions prior to mailing or bringing your application in, please feel free to contact our department at
NJ Hospital Care Assistance Program(NJHCAPS) NJ Hospital Care Assistance Program (formerly known as Charity Care) is available to every patient regardless of whether they are insured or not. Each patient
More informationIndividual Tax Engagement Letter 2017 Tax Returns
Individual Tax Engagement Letter 2017 Tax Returns Dear Client: Thank you for engaging Bailey, Smith & Associates, LLP, ( BSA ), to provide you with income tax compliance services for 2017. We appreciate
More informationCSS/Financial Aid PROFILE Early Application Instructions.
CSS/Financial Aid PROFILE 2013-14 Early Application Instructions www.collegeboard.org INSTRUCTIONS Read the instructions as you fill out the PROFILE Early Application. Mistakes will delay the processing
More informationCITY OF PEVELY PEVELY POLICE DEPARTMENT APPLICATION FOR EMPLOYMENT
CITY OF PEVELY PEVELY POLICE DEPARTMENT APPLICATION FOR EMPLOYMENT 1, (PRINT FULL NAME) HEREBY CERTIFY THAT I HAVE PERSONALLY COMPLETED THIS APPLICATION, THAT ALL STATEMENTS MADE, OR INFORMATION OR DOCUMENTS
More informationWest Chester University. Taxation Issues Nonresident Aliens
West Chester University Taxation Issues Nonresident Aliens Agenda Tax Compliance Issues Nonresident aliens (NRA) o Vendor Payments o Scholarships o Tuition Waivers o Prizes o Stipends Tax related Forms
More informationInstructions for Request for Reduced Fee
Instructions for Request for Reduced Fee Department of Homeland Security U.S. Citizenship and Immigration Services USCIS Form I-942 OMB No. 1615-0133 Expires 11/30/2018 What Is the Purpose of Form I-942?
More informationTAX ORGANIZER. When you drop off your tax information, please bring your Organizer and any of the following that apply to your tax situation:
TAX ORGANIZER Dear Client, Enclosed is your Tax Organizer for tax year 2018. Your Organizer contains several sections that include common expenses and deductions that many taxpayers overlook. Please review
More informationAggregate Verification Form
2019-2020 Aggregate Verification Form Your 2019 2020 Free Application for Federal Student Aid (FAFSA) was selected for review in a process called verification. The law says that, before awarding Federal
More informationStudy Abroad Funding
Study Abroad Funding Student should complete Section A then take the form to the Center for International Education Abroad (BH118) for approval before submitting to the Financial Aid Office (MC 103) with
More informationVirginia Individual Development Accounts Candidate Application
Virginia Individual Development Accounts Candidate Application VIDA candidates must use this application to show that they meet the five criteria below. This form is also used to establish a VIDA savings
More informationClient Contract. Client Full Name: Social Security Number: POA/Guardian Name: Phone: Address:
Client Contract Client Full DOB: Social Security Number: POA/Guardian Phone: _ I, or my advocate, have discussed my needs with my POA/Guardian. I agree to have Thrive serve has my representative payee
More informationST. JAMES PLACE APARTMENTS SRO LTD. 169 Deweese St. Lexington, KY Phone (859) FAX (859)
ST. JAMES PLACE APARTMENTS SRO LTD. 169 Deweese St. Phone (859) 252-6642 FAX (859) 252-3162 Name: Application Processing Checklist (The following items must be completed for residency) [ ] Complete and
More information**Keep in mind that you do not need to mail this print-out to your local agency.**
**Keep in mind that you do not need to mail this print-out to your local agency.** Thank you for using MI Bridges to apply for benefits! Jackson, your application was sent to the following address on May
More informationLOAN CO-APPLICANT FORM
LOAN CO-APPLICANT FORM Thank you for your interest business financing from the NC Rural Center, a non-profit organization focused on self-employment, business creation and economic independence for the
More informationFATHER FRANCIS T. DIETZ, S.J. SCHOLARSHIP APPLICATION FORM Grades 7 & 8 (Gesu Junior High) Grades 9-12 (Area Catholic High Schools)
FATHER FRANCIS T. DIETZ, S.J. SCHOLARSHIP APPLICATION FORM Grades 7 & 8 (Gesu Junior High) Grades 9-12 (Area Catholic High Schools) 2016-2017 APPLICATION NUMBER (For office use only) DATE OF APPLICATION
More informationEMPLOYEE INFORMATION SHEET
EMPLOYEE INFORMATION SHEET PLEASE PRINT CLEARLY COMPANY: EMPLOYEE #: SOCIAL SECURITY NUMBER: - - NAME: First MI LAST STREET: CITY: AS APPEARS ON SOCIAL SECURITY CARD STATE: ZIP CODE: TELEPHONE NUMBER:
More informationSummer U LEAD Program Application
Summer U LEAD Program Application U LEAD is offers a summer job internship program for Ramsey County Suburban youth ages 14 to 24. Youth must complete the summer application and complete work readiness
More informationAddress. PLEASE PRINT. PLEASE ANSWER ALL QUESTIONS! Do not leave any space or blanks, write NO or N/A where appropriate.
APPLICATION for LOW INCOME HOUSING TAX CREDIT (LIHTC) PROPERTY Project Name Unit # No. of Bedrooms Phone (home) (Cell) (work) Current Address: Email Address PLEASE PRINT. PLEASE ANSWER ALL QUESTIONS! Do
More informationAcceptable Dependent Verification Items (Including Spouse as a Dependent)
BILLING EXHIBIT A: APPROVED DOCUMENT LIST We will review and consider household financial income for possible discounted services. Qualification for Financial Assistance depends upon a number of things
More information( ) - FOR APPLICANTS:
Change In Circumstance Form (CCF) 2017 2018 UNC Asheville Office of Financial Aid One University Heights Brown Hall CPO# 1330 Asheville, NC 28804 financialaid.unca.edu (828) 251-6535 Phone (828) 232-2294
More informationESTATE PLANNING QUESTIONNAIRE (SINGLE INDIVIDUAL)
ESTATE PLANNING QUESTIONNAIRE (SINGLE INDIVIDUAL) Thank you for considering Estate Planning & Elder Law Services, P.C. to assist you with the preparation of your estate planning documents. To maximize
More informationInternational Student Certification of Finances
International Student Certification of Finances 2019-20 Return completed form and supporting documentation to Transylvania University via email at admissions@transy.edu. Instructions for completing the
More informationUNC Pharmacy Assistance Program (PAP)
(PAP) INSTRUCTIONS Requirements and Documents for Application If you have questions about the PAP application or the 14 day Temporary PAP Benefit, please call (919) 966-7690, option 1. A counselor is available
More informationChapter 5. Eligibility Determination Process. This chapter covers the eligibility process pertaining to HCRA. It covers the following in detail:
Chapter 5 Eligibility Determination Process This chapter covers the eligibility process pertaining to HCRA. It covers the following in detail: A. The documents that are to be provided and used to verify
More informationSpecial Circumstances Form
2018-2019 Special Circumstances Form Occasionally, unusual circumstances exist that may warrant reconsideration of financial aid eligibility. If the information you reported on your Free Application for
More informationApplication for Employment
Application for Employment We welcome you as an applicant for employment with the City of St. Michael. It is the City of St. Michael s policy to provide equal opportunity in employment. The City of St.
More informationEMPLOYMENT APPLICATION
CITY OF DETROIT LAKES EMPLOYMENT APPLICATION 1025 Roosevelt Avenue, PO Box 647, Detroit Lakes, MN 56502 (218)847-5658 POSITION APPLYING FOR: DATE: PERSONAL INFORMATION NAME: (First/Middle Initial/Last)
More informationDETERMINATION OF RESIDENCY STATUS (LEAVING CANADA)
Canada Revenue Agency Agence du revenu du Canada NR73 E (12) DETERMINATION OF RESIDENCY STATUS (LEAVING CANADA) NOTE: In this form, the text inserted between square brackets represents the regular print
More informationSENTRY PROPERTY MANAGEMENT, INC North Broad Street Colmar, PA PHONE: 215/ or 717/ FAX: 215/
SENTRY PROPERTY MANAGEMENT, INC. 2312 North Broad Street Colmar, PA 18915 PHONE: 215/822-9729 or 717/391-7739 FAX: 215/822-0502 DATE: APPLICANT S NAME(S): PROPERTY: Park Manor Apartments APARTMENT NUMBER:
More informationLPC QUICK CHECK APPLICATION
LPC QUICK CHECK APPLICATION The most recent 2 years resident history required. Must provide dates of residency, landlord names and phone numbers for all addresses. The application cannot be submitted for
More informationDARKO AFFORDABLE HOUSING SOLUTIONS, LLC 125 E Broadway, P.O. BOX 1161 ANADARKO, OK Phone: FAX:
DARKO AFFORDABLE HOUSING SOLUTIONS, LLC 125 E Broadway, P.O. BOX 1161 ANADARKO, OK 73005 Phone: 405-247-1110 FAX: 405-247-4955 STORM SHELTER ASSISTANCE PROGRAM APPLICATION The DAHS Storm Shelter Assistance
More informationSECTION C: Tax Manual I MISC
SECTION C: Tax Manual I. 1099-MISC The Internal Revenue Service requires a 1099-MISC form be issued to independent contractors, other individuals, LLCs, and unincorporated businesses that have received
More informationKoppel Kessler Julie LLP ESTATE PLANNING QUESTIONNAIRE
ESTATE PLANNING QUESTIONNAIRE I. GENERAL INFORMATION DATE: YOUR FULL NAME: FULL NAME OF YOUR SPOUSE: BIRTH DATE: BIRTH DATE: HOME ADDRESS: TELEPHONE: ( ) E-MAIL YOUR CELL SPOUSE S CELL YOUR BUSINESS ADDRESS:
More informationFOREIGN NATIONAL TAX PROCEDURES GUIDE FOR DEPARTMENTS. Document created and modified by Financial Services Revised February 8, 2018
FOREIGN NATIONAL TAX PROCEDURES GUIDE FOR DEPARTMENTS Document created and modified by Financial Services Revised February 8, 2018 Table of Contents Pages Introduction 1 Definition of Terms 2-5 Frequently
More informationOrange County Government Benefits & Wellness Domestic Partner. Benefits Handbook. MY Life MY Health 1 MY Choice
Orange County Government Benefits & Wellness ORANGE COUNTY HEALTH C ARE PREVENTION EDUCATION WELLNESS EMOTIONAL LIFESTYLE FINANCIAL FOR LIFE 2014 Domestic Partner Benefits Handbook MY Life MY Health 1
More informationSAMPLE DISTRIBUTION NOT FOR PERSONAL AND FINANCIAL ORGANIZER FOR YOUR LIVING TRUST GENERAL INFORMATION ABOUT YOUR CHILDREN
1 PERSONAL AND FINANCIAL ORGANIZER FOR YOUR LIVING TRUST GENERAL INFORMATION Marital Status: Married Single Divorced Widowed Home Date E-mail : r Legal Name Spouse s Legal Name Street City State ZIP County
More informationPROBATE ESTATE ADMINISTRATION CHECKLIST
PROBATE ESTATE ADMINISTRATION CHECKLIST The purpose of this Probate Questionnaire is to 1) help prepare you for our upcoming estate settlement consultation; 2) provide us with important personal and asset
More informationSteve H. Hornstein, Esq., CPA, LL.M., CFP Attorney at Law
Steve H. Hornstein, Esq., CPA, LL.M., CFP Attorney at Law www.hornsteinlawoffices.com 20335 Ventura Blvd., Suite 203 Woodland Hills, CA 91364 Office: (818) 887-9401 Toll-free: (888) 280-8100 Fax: (818)
More informationHOW TO APPLY TO BE A SUCCESSOR IN INTEREST
HOW TO APPLY TO BE A SUCCESSOR IN INTEREST A successor in interest is someone with an ownership interest in the property, even though they aren t obliged to repay the loan. You may qualify as a successor
More information